Patch vs. pill: patch loses.

The pill outperformed the contraceptive patch in terms of continuation and effectiveness in a cohort of New York State women, most of whom were at high risk for unintended pregnancy and abortion. (1) The cohort consisted of 1,230 women attending one of three Planned Parenthood clinics between late 2003 and early 2005, of whom 579 obtained the pill and 651 the patch: none had used hormonal contraceptives before. Nine in 10 women were classified as being at high risk because they were younger than 16, were nonwhite or Hispanic, had government health coverage or had had an abortion. Patch users were significantly more likely than pill users not to return to the clinic for follow-up (45% vs. 30%): among those who re turned, patch users were significantly less likely than pill users to continue their method beyond the first 70 days (67% vs. 89%). Continuation of patch use was associated with working full-time but not with other socioeconomic or demographic variables. Over the course of the study, pill users had 3.6 pregnancies per 100 woman-years of use, and patch users had 14.8. The researchers encourage efforts to explore ways that providers can help women at high risk to use the patch effectively.

(1.) Bakhru A and Stanwood N, Performance of contraceptive patch compared with oral contraceptive pill in a high-risk population, Obstetrics & Gynecology, 2006, 108(2):378- 386.

FYI is compiled and written by Dore Hollander; executive editor of Perspectives on Sexual and Reproductive Health.